Application for Privileges
If you wish to apply for privileges at any Inova facility, please complete this downloadable Application Request Form and submit to the Central Verification Office either by email or fax.
Upon receipt of the written request, the Centralized Credentialing Department will initiate the application process. You will receive email communications within two business days.
Note: As part of the application process, you will be asked to acknowledge that you have been furnished with a copy of Inova's Code of Conduct and the Medical Staff Bylaws of each facility at which you are applying for privileges and agree to be bound by the Code of Conduct, Bylaws and Rules/Regulations of the Medical Staff. Links to downloadable PDF versions of each of these documents are provided on the Documents page